Provider Demographics
NPI:1205076130
Name:LANEY, DEAN ARTHUR (RN)
Entity type:Individual
Prefix:MR
First Name:DEAN
Middle Name:ARTHUR
Last Name:LANEY
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:375 NW BEAVER ST.
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PRINEVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97754
Mailing Address - Country:US
Mailing Address - Phone:541-447-5165
Mailing Address - Fax:541-447-3093
Practice Address - Street 1:375 NW BEAVER ST.
Practice Address - Street 2:SUITE 100
Practice Address - City:PRINEVILLE
Practice Address - State:OR
Practice Address - Zip Code:97754
Practice Address - Country:US
Practice Address - Phone:541-447-5165
Practice Address - Fax:541-447-3093
Is Sole Proprietor?:No
Enumeration Date:2009-03-05
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT199782-4405363LF0000X
OR200842264RN163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily